Chagas disease

GARCIA BOURNISSEN FACUNDO; ALTCHEH JAIME; MOSCATELLI GUILLERMO

Congenital and perinatal infections

Oxford university press

Año: 2018; p. 189 - 207

Chagas disease (CD), or American trypanosomiasis, is caused by the hemoflagellate parasite Trypanosoma cruzi. CD is named for the Brazilian physician Carlos Chagas, who discovered the disease in 1909.Patients with CD now can be found throughout the Americas, especially in LatinAmerica, as well as on most continents in the world. CD initially presents with an acute phase of variable duration (2? 8 weeks) characterized by high parasitemia and nonspecific symptoms (e.g., fever, hepatosplenomegaly), followed by a phase known as the chronic asymptomatic phase, which can last for decades before developing into the chronic symptomatic phase in about 30% of patients. CD patients in the chronic symptomatic phase develop cardiac disorders, digestive disorders, or both.In endemic areas with inadequate vector control, CD is usually a vector- bornedisease, with the vector being triatomine insects. Triatomine insects are nocturnal feeders that may live in a variety of environments surrounding human dwellings. After taking a blood meal, infected triatomines excrete feces contaminated with T. cruzi. The parasite can then enter the host via the bite wound or nearby mucosalsurfaces such as the conjunctivae when the subject rubs these parasites across the skin. In areas of endemic countries with effective vector control (e.g., urban areas), CD is usually acquired through mother- to- child transmission (MTCT). With migrations from rural to urban areas in endemic countries, along with migration of populations from endemic countries to nonendemic countries, MTCT has become the primary means of transmission of T. cruzi worldwide. Ingestion of parasitecontaminated food, organ transplantation, and blood transfusion represent other, less common routes of transmission of T. cruzi.